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Comparative Study
. 2013 Apr 11;42(1):28.
doi: 10.1186/1916-0216-42-28.

The impact of clinical versus pathological staging in oral cavity carcinoma--a multi-institutional analysis of survival

Vincent L Biron  1 , Daniel A O'Connell, Hadi Seikaly
Affiliations
Comparative Study

The impact of clinical versus pathological staging in oral cavity carcinoma--a multi-institutional analysis of survival

Vincent L Biron et al. J Otolaryngol Head Neck Surg. .

Abstract

Objectives: To evaluate any disparity in clinical versus pathological TNM staging in oral cavity squamous cell carcinoma (OCSCC) patients and any impact of this on survival.

Design: Demographic, survival, staging, and pathologic data on all patients undergoing surgical treatment for OCSCC in Alberta between 1998 and 2006 was collected. Clinical and pathological TNM staging data were compared. Patients were stratified as pathologically downstaged, upstaged or unchanged.

Setting: Tertiary care centers in Alberta, Canada.

Main outcome measures: Survival differences between groups were analyzed using Kaplan-Meier and Cox regression models.

Results: Patients with clinically early stage tumors were pathologically upstaged in 21.9% of cases and unchanged in 78.1% of cases. Patients with clinically advanced stage tumors were pathologically downstaged in 7.9% of cases and unchanged in 92.1% of cases. Univariate and multivariate estimates of disease-specific survival showed no statistically significant differences in survival when patients were either upstaged or downstaged.

Conclusions: Some disparity exists in clinical versus pathological staging in OCSCC, however, this does not have any significant impact on disease specific survival.

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Figures

Figure 1
Figure 1
Upstaging and downstaging in early vs late stage oral cavity squamous cell carcinoma in 379 patients.
Figure 2
Figure 2
Kaplan-Meir estimates of disease-specific survival according to stage discrepancy. Blue, early stage patients with no change. Green, early stage patients upstaged to advanced stage. Purple, advanced stage patients with no change. Gold, advanced stage patients downstaged to early stage.
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